The Role of Prophylactic Ipsilateral Distal Femoral Artery Cannulation in Preventing Periprocedural Peripheral Complications During Transcatheter Aortic Valve Implantation

OBJECTIVE
Access site-related vascular complications are common complications of trans-catheter aortic valve replacement. In this study, we aimed to investigate the efficacy and safety of prophylactic cannulation of the ipsilateral distal femoral artery in the management of access site-related vascular complications.


METHODS
One hundred sixty-four patients, who were evaluated by the Heart Team of our institution and found eligible for transcatheter aortic valve replacement procedure between January 2016 and August 2019, were included in this retrospective study. Patients were divided into two groups according to the management of peripheral complications. The antegrade crossover was used as bailout treatment in the first 70 patients. Prophylactic cannulation of the ipsilateral distal femoral artery was performed in the last 94 patients. These 2 groups were compared.


RESULTS
Peripheral complications developed in 15 of the first 70 patients included in the study. The percutaneous intervention was unsuccessful in 4 of the patients who underwent bailout antegrade crossover. Peripheral complications developed in 14 of the last 94 patients in whom prophylactic cannulation of the ipsilateral distal femoral artery was performed, and all these patients were managed successfully with percutaneous intervention.


CONCLUSION
Prophylactic cannulation of the ipsilateral distal femoral artery is a simple, effective, and safe method in the management of access site-related vascular complications.